Provider Demographics
NPI:1598896920
Name:SHAIKH, MUHAMMAD GOLAM R (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:GOLAM R
Last Name:SHAIKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BRISTOL DRIVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-5206
Mailing Address - Country:US
Mailing Address - Phone:845-695-1847
Mailing Address - Fax:845-615-3066
Practice Address - Street 1:16 BRISTOL DRIVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-5206
Practice Address - Country:US
Practice Address - Phone:845-695-1847
Practice Address - Fax:845-615-3066
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117866207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D38121Medicare UPIN